[Ortho] Fixion

[Andrey Sereda]

Александр Николаевич, здравствуйте. Скажите, пожалуйста, почему Вы
выбрали Fixion именно в этом случае- остеопороза нет, патологии кости
нет. Если без блокированя,то не боитесь ли укорочения? На нашем
отделении нет опыта применения fixion, но с интересом смотрим на
пионеров. Спасибо.    

J Orthop Trauma. 2006 May;20(5):310-314.
Expandable Intramedullary Nailing for Tibial and Femoral Fractures: A
Preliminary Analysis of Perioperative Complications.
Smith WR, Ziran B, Agudelo JF, Morgan SJ, Lahti Z, Vanderheiden T,
Williams A. 
*Department of Orthopaedic Surgery, Denver Health Medical Center
daggerDepartment of Orthopaedic Surgery, St. Elizabeth's Health
System, Youngstown, Ohio double daggerDepartment of Orthopaedic
Surgery, University of Colorado Health Sciences Center.   
OBJECTIVE: To report the results of using the expandable nailing
system in the treatment of femoral and tibial shaft fractures. DESIGN:
Prospective, cohort series. SETTING: Two level-1 university trauma
centers. PARTICIPANTS: Forty-eight patients with acute, traumatic
diaphyseal fractures of the tibia or femur. INTERVENTION: Internal
fixation of lower extremity long bone fractures using expandable
intramedullary nailing. MAIN OUTCOME MEASUREMENTS: Perioperative
complications and time to healing. RESULTS: Forty-nine long bone
fractures were treated: 22 femoral fractures (OTA classification: 4
type A1, 6 A2, 7 A3, 1 B1, and 4 B2) and 27 tibial fractures (OTA
classification: 4 type A1, 11 A2, 9 A3, 0 B1, and 3 B2). There were 13
open fractures and 37 closed fractures. Healing occurred in 37 (75%)
fractures without additional interventions. There were 2 tibial
delayed unions and 1 femoral and 1 tibial nonunion. Five tibial shaft
fractures and 6 femoral fractures shortened by 1.0 cm or more
postoperatively. In 3 tibias and 4 femurs, shortening occurred after
fractures judged to be length-stable became unstable because of
fracture propagation during nail expansion. Five tibias and 3 femurs
were converted to standard locked nails because of shortening. The
average time to healing, excluding nonunion, was 15 weeks in the tibia
and 16 weeks in the femur. The expandable nail resulted in an
unplanned reoperation in 12 cases (25%). CONCLUSION: We found a high
complication rate because of shortening, which was independent of
fracture classification. Consequently, we cannot recommend the use of
an unlocked, expandable nail in diaphyseal fractures of the femur or
tibia.                         
PMID: 16766932 [PubMed - as supplied by publisher]
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Andrey Sereda